Psychogenic Dizziness: An Important but Overlooked Differential Diagnosis in the Workup of the Dizzy Patient

2018 ◽  
Vol 118 (5) ◽  
pp. e22
Author(s):  
Zak Kelm ◽  
Kimberly Klapchar ◽  
Christopher R. Kieliszak ◽  
Christopher Selinsky
Keyword(s):  
Differential Diagnosis ◽  
Psychogenic Dizziness ◽  
Dizzy Patient

Acute Dizziness

2019 ◽  
Vol 39 (01) ◽  
pp. 027-040 ◽  
Author(s):  
Jonathan Edlow ◽  
Kiersten Gurley
Keyword(s):  
Differential Diagnosis ◽  
Physical Examination ◽  
Traditional Approach ◽  
Diagnostic Testing ◽  
Positional Vertigo ◽  
Acute Vestibular Syndrome ◽  
Associated Symptoms ◽  
Ischemic Attack ◽  
Dizzy Patient ◽  
Paroxysmal Positional Vertigo

AbstractDizziness is a common chief complaint with an extensive differential diagnosis that includes both benign and serious conditions. Physicians must distinguish the majority of patients who suffer from self-limiting conditions from those with serious illnesses that require acute treatment. The preferred approach to the diagnosis of an acutely dizzy patient emphasizes different aspects of the history to guide a focused physical examination, with the goal of differentiating benign peripheral vestibular conditions from dangerous posterior circulation strokes. Currently, misdiagnoses are frequent and diagnostic testing costs are high. This partly relates to use of an outdated diagnostic paradigm. This commonly used traditional approach relies on dizziness “symptom quality” or “type” (vertigo, presyncope, disequilibrium) to guide inquiry. It does not distinguish benign from dangerous causes and is inconsistent with current best evidence. A better approach categorizes patients into three groups based on timing and triggers. Each category has its own differential diagnosis and targeted bedside approach: (1) acute vestibular syndrome, where bedside physical examination differentiates vestibular neuritis from stroke; (2) spontaneous episodic vestibular syndrome, where associated symptoms help differentiate vestibular migraine from transient ischemic attack; and (3) triggered episodic vestibular syndrome, where the Dix-Hallpike and supine roll test help differentiate benign paroxysmal positional vertigo from posterior fossa structural lesions. The “timing and triggers” diagnostic approach for the acutely dizzy derives from current best evidence and offers the potential to reduce misdiagnosis while simultaneously decreasing diagnostic test overuse, unnecessary hospitalization, and incorrect treatments.

Tumor Diagnosis

1982 ◽  
Vol 40 ◽  
pp. 262-265
Author(s):  
Bruce Mackay
Keyword(s):  
Electron Microscopy ◽  
Transmission Electron Microscopy ◽  
Differential Diagnosis ◽  
Light Microscopy ◽  
Clinical Examination ◽  
Ultrastructural Study ◽  
Diagnostic Procedures ◽  
Specific Diagnosis ◽  
Transmission Electron ◽  
Microscopic Diagnosis

The broadest application of transmission electron microscopy (EM) in diagnostic medicine is the identification of tumors that cannot be classified by routine light microscopy. EM is useful in the evaluation of approximately 10% of human neoplasms, but the extent of its contribution varies considerably. It may provide a specific diagnosis that can not be reached by other means, but in contrast, the information obtained from ultrastructural study of some 10% of tumors does not significantly add to that available from light microscopy. Most cases fall somewhere between these two extremes: EM may correct a light microscopic diagnosis, or serve to narrow a differential diagnosis by excluding some of the possibilities considered by light microscopy. It is particularly important to correlate the EM findings with data from light microscopy, clinical examination, and other diagnostic procedures.

The Preschool Stuttering Screen for Health Care Professionals

2011 ◽  
Vol 21 (2) ◽  
pp. 59-62
Author(s):  
Joseph Donaher ◽  
Christina Deery ◽  
Sarah Vogel
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Differential Diagnosis ◽  
Preschool Children ◽  
Health Care Professionals ◽  
Healthcare Professionals ◽  
Evidence Based ◽  
Developmental Profile

Healthcare professionals require a thorough understanding of stuttering since they frequently play an important role in the identification and differential diagnosis of stuttering for preschool children. This paper introduces The Preschool Stuttering Screen for Healthcare Professionals (PSSHP) which highlights risk factors identified in the literature as being associated with persistent stuttering. By integrating the results of the checklist with a child’s developmental profile, healthcare professionals can make better-informed, evidence-based decisions for their patients.

The Effect of Sensori-Neural Hearing Loss on Threshold-Duration Functions

1968 ◽  
Vol 11 (4) ◽  
pp. 842-852 ◽  
Author(s):  
H. N. Wright
Keyword(s):  
Hearing Loss ◽  
Differential Diagnosis ◽  
Time Constant ◽  
Present Series ◽  
Auditory Disorders ◽  
Threshold Duration

Previous findings on the threshold for tones as a function of their duration have suggested that such functions may be systematically affected by sensori-neural hearing losses of cochlear origin. The present series of investigations was designed to explore this relation further and to determine also whether the amount of hearing loss present has any effect upon the results which are obtained. Preliminary studies were also carried out on a conductively impaired listener to indicate whether hearing losses of this type affect the threshold-duration function. The results indicate that the threshold-duration function is systematically affected by sensori-neural hearing losses of cochlear origin. This effect is manifested by a progressive shortening of the time constant relating threshold to duration and is not uniquely related to the amount of hearing loss present. The results obtained from the conductively impaired listener suggested that this type of hearing loss has no effect on the threshold-duration function, thereby implying that such functions may contribute significantly to the differential diagnosis of auditory disorders.

POST-TRANSFUSION PURPURA VS. HEPARIN-INDUCED THROMBOCYTOPENIA: DIFFERENTIAL DIAGNOSIS IN CLINICAL PRACTICE

2000 ◽  
Vol 10 (4) ◽  
pp. 323-324 ◽  
Author(s):  
F. Araujo ◽  
J. J. Sa ◽  
V. Araujo ◽  
M. Lopes ◽  
L. M. Cunha-Ribeiro
Keyword(s):  
Differential Diagnosis ◽  
Clinical Practice ◽  
Heparin Induced Thrombocytopenia

A Historical Review of Complex Regional Pain Syndrome in the “Guides Library”

2009 ◽  
Vol 14 (6) ◽  
pp. 1-9
Author(s):  
Robert J. Barth
Keyword(s):  
Differential Diagnosis ◽  
Complex Regional Pain Syndrome ◽  
Reflex Sympathetic Dystrophy ◽  
International Association ◽  
Historical Review ◽  
Pain Syndrome ◽  
Sixth Edition

Abstract Complex regional pain syndrome (CRPS) is a controversial, ambiguous, unreliable, and unvalidated concept that, for these very reasons, has been justifiably ignored in the “AMA Guides Library” that includes the AMAGuides to the Evaluation of Permanent Impairment (AMA Guides), the AMA Guides Newsletter, and other publications in this suite. But because of the surge of CRPS-related medicolegal claims and the mission of the AMA Guides to assist those who adjudicate such claims, a discussion of CRPS is warranted, especially because of what some believe to be confusing recommendations regarding causation. In 1994, the International Association for the Study of Pain (IASP) introduced a newly invented concept, CRPS, to replace the concepts of reflex sympathetic dystrophy (replaced by CRPS I) and causalgia (replaced by CRPS II). An article in the November/December 1997 issue of The Guides Newsletter introduced CRPS and presciently recommended that evaluators avoid the IASP protocol in favor of extensive differential diagnosis based on objective findings. A series of articles in The Guides Newsletter in 2006 extensively discussed the shortcomings of CRPS. The AMA Guides, Sixth Edition, notes that the inherent lack of injury-relatedness for the nonvalidated concept of CRPS creates a dilemma for impairment evaluators. Focusing on impairment evaluation and not on injury-relatedness would greatly simplify use of the AMA Guides.

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